Transperitoneal laparoscopic renal denervation for the management of loin pain haematuria syndrome

Abstract

Objectives: To assess the role of laparoscopic renal denervation as a surgical option in loin pain-haematuria syndrome (LPHS), refractory to conservative treatment. Material and methods: Nine patients between 2000 and 2010 with a diagnosis of LPHS following extensive investigations. The data collection from medical records and electronic databases included demographic details, details of surgical procedures, perioperative outcomes, pain recurrences and ongoing analgesia requirements. A telephone follow-up was conducted after at least one year after the procedure for each patient using the Pain Impact Questionnaire (PIQ-6TM) to assess impact of pain on their quality of life. Results: Nine patients (nine women; median age 37 years) underwent 11 laparoscopic denervations. The median follow-up was 28 months. The median operative time was 150 min. There were no significant postoperative complications. In four patients (44%) laparoscopic denervation procedures were curative (median follow-up 70.5 months). The analgesic requirement was significantly reduced in 22% of patients. Telephone follow-up confirmed that 66.66% of the patients had better quality of life after the procedure. Conclusions: Laparoscopic renal denervation is a feasible and safe alternative to open procedures in patients with refractory LPHS, producing good outcomes in terms of pain-free rates and quality of life impact.

Key words::

• Laparoscopy
• loin-pain haematuria syndrome
• kidney
• pain impact questionnaire

Acknowledgments

The authors wish to thank Mr Malcolm Barton MBE, FRSA for his illustrations.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.